Therapie des chronisch-komplexen Tinnitus

Tinnitus ist ein Ph?nomen, welches für fast jeden Menschen physiologisch unter ruhigen Umgebungsbedingungen subjektiv wahrnehmbar wird. Im psychosomatisch-psychotherapeutischen Setting ist dieses Symptom in der Regel im Rahmen einer Somatisierungsst?rung (F45.0; F45.1) oder des chronisch-komplexen Tinnitus (F54.0, H93.1) anzutreffen. In der vorliegenden Arbeit wird ein integrativer HNO-?rztlicher und psychosomatischer Therapieansatz vorgestellt: Ziel der Behandlung ist es, die Komponenten der akustischen Wahrnehmung zu reorganisieren, das Ohrger?usch und die psychisch emotionale Wertung zu entkoppeln sowie dessen psychologische Bedeutung zu ?ndern. Weiters wird ein Modell vorgestellt, wie die Depression – als h?ufigste komorbide Achse-I-St?rung – in das diagnostisch- therapeutische Erkl?rungsmodell integriert werden kann. Zuletzt werden M?glichkeiten er?rtert, wie Patienten mit chronisch-komplexem Tinnitus zur Aufnahme einer psychotherapeutischen Behandlung motiviert werden k?nnen.     

Drogenabhängige Patienten im Maßregelvollzug gemäß § 64 StGB: Verbesserung der Quote erfolgreicher Behandlung durch suchtspezifische Medikation?

In Germany, addicted offenders can be sentenced to compulsory addiction treatment in forensic mental hospital departments (Art. 64 of the penal code). A presupposition to such a sentence is a fair chance of successful treatment and rehabilitation. Commonly, an expert witness is asked by the court to assess this point in the trial. To date, the treatment in forensic mental hospitals aims at total abstinence from any kind of drugs. But in at least half of the cases, a fair chance of successful treatment is no longer seen after a period of therapy. In most cases, these patients are returned to prison. The paper pleads that in offenders addicted to illegal drugs, a drug specific medication – in particular methadone maintenance treatment or naltrexone medication – might be a useful option. The rate of “treatment failure” might be reduced slightly by using this option with some of the patients.     

Dimensionale versus kategoriale Klassifikation von Pers?nlichkeitsst?rungen

The classification systems DSM-IV and ICD-10 are characterized by a categorical conception of personality disorders. This perspective has long been criticized for a number of reasons and a dimensional perspective plays a major role in the debate. For both approaches, advantages and disadvantages can be discussed and a categorical-dimensional hybrid approach will most likely be established in the revised classification systems ICD-11 and DSM-V. An integration of a categorical and a dimensional??quantifying??perspective has always been a standard in the field of forensic psychiatric assessment. A general hybrid approach of defining personality disorders appears suitable, promising and feasible.     

Sleep hygiene behaviours: an application of the theory of planned behaviour and the investigation of perceived autonomy support, past behaviour and response inhibition

This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.     

Der Gruppenfragebogen (GQ-D)

An investigation of the psychometric properties of the German version of the Group Questionnaire (GQ; Krogel 2009) is described. The GQ is a self-report instrument economically enabling the assessment of helpful aspects of relationships within small groups. Due to the limited length of the questionnaire it provides a tool of monitoring bonding to the group, the quality of the working relationship as well as negative aspects during group treatment. One advantage of the GQ is that it measures relationships on three different relational levels (group members, group leader and the group as a whole). Following a test of the multidimensional structure of the GQ-D using data from a multisite study (N=438) with structural equation models, the GQ-D was validated using other process measures. The GQ-D proved to be an objective, valid and reliable measure to assess relevant therapeutic relationships within groups.     

Psychotherapie, Globalisierung, Hartz?IV

The mental effects of globalization, the economic crisis and unemployment must not be underestimated. In general they have to be looked upon as a complex system of structural traumatization which is causing severe psychological mental disorders, such as depression. Not only that, a psychotherapist has to pay particular attention to this. More than in physical illnesses the psychotherapist has to be solidly united with the patient, which might also result in political action.     

Sexualit?t und Internet

On the discussion about sexual internet activities, the professional and public discourses have been strongly polarized for a long time. Currently the trend is that online sexuality is to be seen in a differentiated and empirical manner. Next to undesired (e.g. assault by internet platform) or indirect (e.g. due to excessive pornography use by partners) confrontations with online sexuality, there is a broad spectrum of self-initiated sexual use of the internet. These are, for example reception of information sites, exchange of experiences, utilization of online sexual consultation and romantic relationships. On the other hand clinically relevant problems could accompany sexual internet use, such as cybersex addiction. Because of the mediatization in society ambulant patients in the psychotherapeutic practice are more informed about sexual internet use. For psychotherapists it is important to know the internet-specific details and the potential risks and chances for sexual behavior in order to know how to deal with the situation and if necessary to integrate the internet into the spectrum of web-based sexual therapeutic options.